Type 2 diabetes remission after Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and one anastomosis gastric bypass (OAGB) : results of the longitudinal assessment of bariatric surgery study

Acknowledgements The authors would like to thank the staff at the Minimally Invasive Surgery Research Center (MISRC) in Rasoul-e-Akram Hospital. Funding Information: This study was supported by the Deputy of Research of Iran University of Medical Sciences, Tehran, Iran.Peer reviewedPublisher PD

Bilateral Antepartum Mastitis

Antepartum mastitis is a rare condition, whereas postpartum orlactation mastitis is a common problem. This report introducesa case of complicated bilateral antepartum mastitis, which wastreated successfully by drain insertion and antibiotic therapy.The patient was a 23-year-old woman in the 23rd week of herfirst pregnancy. Her chief complaint was progressive swelling,redness and radicular pain in both breasts, which had beenstarted gradually from the 18th week of pregnancy. The patientwas admitted to hospital, and received oral and intravenous antibioticsempirically, which was not effective. The patient wastreated by drainage and oral antibiotic therapy. Based on theapproaches employed and the outcomes achieved it is suggestedthat early surgical insertion in the presence of fluid collection inantepartum mastitis will shorten hospitalization and course ofintravenous antibiotic therapy.Iran J Med Sci 2010; 35(4): 327-330

A rare case of mixed gonadal dysgenesis with mosaicism 45, X/46, X, +mar

Introduction: We present a rare patient case with mixed gonadal dysgenesis as a disorder of sex development (DSD) and a new pattern of chromosome in the karyotype, 45, X/46, X, +mar(Y). Presentation of case: A ten-year-old boy, raised in a nursery center, presented with ambiguous genitalia. Two cell lines, (45, X) and [46,X, +mar(Y)] were observed utilizing cytogenetic investigation including fluorescence in situ hybridization (FISH) which were carried out on his peripheral lymphocytes. A significantly higher percentage (75%) of Y-containing cells was observed in the blood, which could be considered the major reason why the case did not have distinct ambiguous genitalia. A further explorative laparoscopic procedure was performed, during which orchiectomy was performed, and remnants of Müllerian duct were excised. Discussion: A complete and sufficiently careful medical evaluation and genetics counseling of neonates is highly recommended in order to avoid any delayed insufficient diagnostic, conservative, and therapeutic care in children living with guardians rather than their biological parents. Both molecular and cytogenetic studies are recommended in some DSDs to help early diagnosis of the disease, which is important for further essential surgical approaches. Conclusion: Cytogenetic studies followed by a laparoscopic exploratory and surgical survey are helpful tools for unraveling the mosaicism involving sex chromosomes and the complicated process in mixed gonadal dysgenesis patients

Minimally invasive surgical interventions in the treatment of primary persistent hyperinsulinemic hypoglycemia of infancy

Hyperinsulinemia, diagnosed by laboratory tests, should be diagnosed and treated as soon as possible to prevent fatal complications such as neurological damage. Patients who are resistant to medical therapy should be treated surgically. Minimally invasive surgery, a newly developed approach, is a good choice among surgical procedures to avoid unnecessary extensive pancreatectomy. Here, a 12-year-old boy is presented with diagnosis of hyperinsulinemic hypoglycemia who had recurrent attacks of hypoglycemia and seizures from infancy. Because of his unresponsiveness to medical therapy and his family’s preference, he underwent laparoscopic pancreatectomy to reduce morbidity and hospital stay. Two years postsurgical follow-up revealed a normo-glycemic state